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全膝人工关节股骨假体屈曲原因分析及其对疗效影响
引用本文:张洪美,孙钢,赵铁军,顾力军,陈卫衡,尹天,刘道兵,张淳. 全膝人工关节股骨假体屈曲原因分析及其对疗效影响[J]. 中国骨伤, 2006, 19(7): 389-391
作者姓名:张洪美  孙钢  赵铁军  顾力军  陈卫衡  尹天  刘道兵  张淳
作者单位:中国中医科学院望京医院骨关节一科,北京,100102
摘    要:目的:探讨全膝人工关节置换(TKR)术中股骨假体屈曲的原因及其对疗效的影响。方法:回顾性分析全膝人工关节置换手术123膝(78例),发现17膝股骨假体发生不同程度的屈曲,106膝无屈曲。比较股骨假体屈曲组和非屈曲组手术前后的HSS评分、膝关节活动范围和屈曲挛缩畸形等情况,并测量屈曲角(∠CAB)和屈曲距离(BC)。结果:∠CAB为7°~19°,平均11.3;°BC为2~4 mm,平均2.6 mm。经过平均38个月(15~50个月)的随访,HSS评分和膝关节活动范围,术前屈曲组与非屈曲组均无显著性差异(P>0.05),但术后屈曲组明显低于非屈曲组(P=0.01或P<0.01);术后均显著高于术前(P=0.02或P<0.01)。术后屈曲挛缩例数和角度均具有显著性差异(P<0.01),屈曲组明显多于和大于非屈曲组,两组术后与术前相比均有显著差异(屈曲组P<0.05,非屈曲组P<0.01),即各组术后屈曲挛缩均有明显改善。结论:在TKR术中发生股骨假体屈曲的主要原因是非水平安装、股骨后髁截骨量不足、前后髁屈曲位截骨和股骨后髁骨赘清除不彻底等,而股骨假体屈曲对TKR手术疗效的主要影响是增加术后膝关节屈曲挛缩发生率,造成伸膝功能障碍。

关 键 词:全膝关节置换  假体屈曲  股骨髁
收稿时间:2006-02-22
修稿时间:2006-02-22

Reason analysis of femoral prosthesis flexion in total knee replacement and its influence on curative effect
ZHANG Hong-mei,SUN Gang,ZHAO Tie-jun,GU Li-jun,CHEN Wei-heng,YIN Tian,LIU Dao-bing and ZHANG Chun. Reason analysis of femoral prosthesis flexion in total knee replacement and its influence on curative effect[J]. China journal of orthopaedics and traumatology, 2006, 19(7): 389-391
Authors:ZHANG Hong-mei  SUN Gang  ZHAO Tie-jun  GU Li-jun  CHEN Wei-heng  YIN Tian  LIU Dao-bing  ZHANG Chun
Affiliation:The First Department of Bone and Joint,Wangjing Hospital of China Academy of Chinese Medicine Sciences,Beijing 100102,China;The First Department of Bone and Joint,Wangjing Hospital of China Academy of Chinese Medicine Sciences,Beijing 100102,China;The First Department of Bone and Joint,Wangjing Hospital of China Academy of Chinese Medicine Sciences,Beijing 100102,China;The First Department of Bone and Joint,Wangjing Hospital of China Academy of Chinese Medicine Sciences,Beijing 100102,China;The First Department of Bone and Joint,Wangjing Hospital of China Academy of Chinese Medicine Sciences,Beijing 100102,China;The First Department of Bone and Joint,Wangjing Hospital of China Academy of Chinese Medicine Sciences,Beijing 100102,China;The First Department of Bone and Joint,Wangjing Hospital of China Academy of Chinese Medicine Sciences,Beijing 100102,China;The First Department of Bone and Joint,Wangjing Hospital of China Academy of Chinese Medicine Sciences,Beijing 100102,China
Abstract:
Keywords:Total knee replacement  Prosthesis flexion  Condyle of femur
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